Separate and Unequal

You have just fallen off your bike. You hit a rock and were thrown over the handlebars onto your back. Ouch.

What do you do now? You go to the doctor. X-rays are taken. Nothing is broken. You get some medicine, you go home.

The next day at work, you are having some trouble with the pain. Your peers ask what’s wrong. You reply that you fell off your bike. They say that’s too bad; hope you feel better. Move on. They don’t think too much of it.

Now, let’s pretend you had a different kind of health issue. Lately you’ve been feeling down. You can’t explain why, you just don’t feel like doing anything. You aren’t hungry, and are disinterested in things that usually excite you. So you go into work and your peers have noticed your mood shift.

They ask about it, wondering if you’re OK. You tell them you’ve been feeling sad and can’t really explain it. They tell you you’ll get over it. You’ll come out of this slump you’re in. Just try a little harder to be happy.

How would you respond if they told you to “just try a little harder” when you’ve got a broken bone? You can’t try a little harder. It takes as long as it takes to heal.

This is a common response when people are talking about depression, and many other mental illnesses. They think it’s your fault, and that you aren’t trying hard enough to get better. But that’s not how mental illnesses work. This opinion is rooted in misunderstanding and generalizations about the impact of mental illness.

This is a primary example of the stigma surrounding mental illness. Many see it as fake and easily overcome. For example, Dr. Michael Karson believes that sympathy given to people suffering from mental illness is detrimental to their getting better. He believes that some mental illnesses are behavioral, and when we excuse the actions of those people, we are reinforcing their behavior.

This only serves to worsen the stigma surrounding mental illness. It gives us the notion that serious mental illnesses are purposely made up by people seeking attention. While this does occur, many people who are faking a mental illness are more likely to also have a real mental illness, according to an article on WebMD.

In a study published in the U.S. National Library of Medicine, it was found that the knowledge of or suspicion of a mental illness can have a negative impact on a hospital stay. This thought held by some health professionals doesn’t bode well for those suffering from mental illness.

In fact, a recent study in the Health Affairs Journal found that doctors don’t follow up with patients suffering from depression as often as they should and are less likely to help these patients manage their illness. This same study also found that most primary care practices aren’t equipped to handle depression as a chronic illness. Although they are not mental health specialists, primary care doctors should be equipped to refer patients to therapists and psychiatrists.

According to Ranna Parekh, the director of the division of diversity and health equity for the American Psychiatric Association, there is a separation between mental and physical health.

She says that the longer we continue to refer to them as separate, the longer we will treat and view them differently. Health needs to be an all-inclusive term. This will reduce a separation in thinking that comes along with a separation of terms. When we refer to someone as being in poor health, we are usually talking about a broken arm, or having a harder time breathing, or being slow to get around. Being in poor health needs also to include mental health. Mental illnesses need to have the same amount of credibility and awareness as physical illnesses.

If physical and mental health were thought of as one entity, health, then there wouldn’t be such a separation in thinking about these two things. It would all be talked about in the same breath and making separations and comparisons would be harder to do. It would force us to think of health as a combination of mind and body, not a separation.

There are currently efforts to try to achieve parity in health. For example, The Mental Health Parity and Addiction Equity Act, passed in 2008, requires that financial requirements and treatment limitations be no more restricting than those applied to physical health care. This exemplifies the movement to end stigma and get to a point where mental and physical health are equals.

This movement needs to happen. There are many people around the world who are suffering from a mental illness. Their suffering is only made worse when they are treated differently and ostracized, and made to feel shameful about something that is normal. The world will be a happier and healthier place once health is an all-inclusive term.